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• • -- -- <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org C� �. l{ —13 <br /> Ei3a9 -or�f <br /> �.4� �—I (� !�U-t ., l�Gt,� _ <br /> PROJECT ADDRESS <br /> � O�� � �Q (`C� 1�1` a. S���Q13� <br /> Owner Mad�daress Gty State/Lp Phone <br /> Tenanl Mail Adtlress Ciry State2�p Phone <br /> ��I ►__--��� �-�s,�,� Fv-�--� ��.__ y�=�� � <br /> ' Eledrical Co ractor Mal Addies Cdy State/Lp Phone <br /> F v �� �r� �a ov4 KG SOo � <br /> State license Number Contract Price of Work <br /> Pioposed Use of E3wlding GoMact Person (Plan Review) <br /> I <br /> Square Footage (If residenUal new construction, remodel or addibon) <br /> Number of devices (II low vo�tage) <br /> Descripllon ol Work lo Be Done ��� � ��SL]��__�-rr1n_�_ _ _—._ , <br /> I — -- ---- - — — — <br /> I -------- --- — -- ---- - � - <br /> FFE <br /> CITV OF EVERETT LOCAL SALES TAX CODE IS 3105 �oO� <br /> i <br /> I hr.rohy ceiirly Ihaf I have read and examined this applicalion and know fhe;ame(o be huc and __________ <br /> corrr.r,l All provisions ollaws anJ ordinances,•�veminy Ihis fype al work wdl6r, r,ornplefr.J — - <br /> whefher speci/red herein or nof. The girmfing o/a pr,�md Joes nol piesume lo groc aufhonty(a PERMI 1-1/ <br /> vrolate or r,oncel!hn provisrons o!nny ofHe�slafe or local law rogulating conslrucLon or Ihe � � �O� <br /> pr.�lonnance ol constnnlion. Thal 1 am aulhonzed by the ownerol0iis property fo peAomi(he l <br /> wurk!nr wlnch app6cafron is made and I comply wAh 1he Sfate Confraclors l.aw 78.21 RCW and _____- O 1 _ ___ <br /> 29 WAC. <br /> � Vw��..� � <br /> ---y 1-y��� ---- <br /> � S�qnat�re U ... -- Uatc <br /> m vr,e-n v;w�� <br />